Squillaci Ettore, Bolacchi Francesca, Altobelli Simone, Franceschini Luca, Bergamini Alberto, Cantonetti Maria, Simonetti Giovanni
University Hospital Policlinico Tor Vergata, Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome "Tor Vergata", Rome, Italy.
University Hospital Policlinico Tor Vergata, Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome "Tor Vergata", Rome, Italy
Acta Radiol. 2015 Jun;56(6):733-8. doi: 10.1177/0284185114538792. Epub 2014 Jun 27.
Multiple myeloma (MM) is a hematologic malignancy characterized by the clonal proliferation of plasma cells. Accurate staging is of pivotal importance in the management of MM. Advanced imaging techniques, such as magnetic resonance imaging (MRI), are increasingly used for the initial diagnosis and staging of MM.
To compare whole-body (WB) MR diffusion-weighted imaging with background body signal suppression (DWIBS) with (WB) MR fat-suppressed T1-weighted contrast-enhanced imaging (T1-CE) in the pre-treatment staging evaluation of multiple myeloma (MM) patients.
Thirty-six patients with MM were included in the study. T1-CE and DWIBS were performed using a 3 T scanner. The Durie-Salmon plus staging system was used. Kappa statistics was used to assess agreement.
For all MM stages good to very good agreement was found for both T1-CE and DWIBS. The unweighted kappa statistic indicated a moderate, good and very good agreement between T1-CE and DWIBS for stages I, II, and III, respectively. In particular, in 67% of patients the MM staging according to T1-CE was not different from DWIBS. In the remaining 33% of patients, the MM stage obtained with T1-CE was lower than that provided by DWIBS.
DWIBS and T1-CE were concordant in the majority of patients. In a minority of cases DWIBS evidenced areas of water restriction that did not correspond to contrast enhancement areas. Studies monitoring therapeutic response in relation to tumour burden and aggressiveness should be performed to assess the clinical relevance of DWIBS findings.
多发性骨髓瘤（MM）是一种以浆细胞克隆性增殖为特征的血液系统恶性肿瘤。准确分期在MM的管理中至关重要。先进的成像技术，如磁共振成像（MRI），越来越多地用于MM的初始诊断和分期。
比较全身磁共振扩散加权成像背景体部信号抑制（DWIBS）与全身磁共振脂肪抑制T1加权对比增强成像（T1-CE）在多发性骨髓瘤（MM）患者治疗前分期评估中的作用。
36例MM患者纳入研究。使用3T扫描仪进行T1-CE和DWIBS检查。采用Durie-Salmon plus分期系统。使用Kappa统计量评估一致性。
对于所有MM分期，T1-CE和DWIBS均显示出良好至非常好的一致性。未加权Kappa统计量表明，T1-CE和DWIBS在I期、II期和III期分别显示出中度、良好和非常好的一致性。特别是，67%的患者根据T1-CE得出的MM分期与DWIBS无差异。在其余33%的患者中，T1-CE得出的MM分期低于DWIBS提供的分期。
大多数患者中DWIBS和T1-CE结果一致。少数情况下，DWIBS显示的水扩散受限区域与对比增强区域不对应。应开展关于肿瘤负荷和侵袭性的治疗反应监测研究，以评估DWIBS结果的临床相关性。
